USE OF FLUOROQUINOLONES IN HOSPITALIZED CHILDEN, PRELIMINARY REPORT OF A CHART REVIEW IN A BELGIAN UNIVERSITY CHILDREN'S HOSPITAL
Bibliographic record
Abstract
According to international guidelines, fluoroquinolones (FQ) should only be prescribed to children when there is no alternative antibiotic. FQ resistance is a rapidly growing problem worldwide. We hypothesize that FQ are frequently prescribed off-label in children. To confirm this hypothesis, we analyzed FQ prescriptions for hospitalized children in a Belgian university hospital. Method We reviewed all prescriptions of FQ for children up to 17 years of age who were hospitalized at Universitair Ziekenhuis Brussel, a Belgian university children's hospital, in the period 2010–2013. Patient characteristics, indication for the FQ prescription and microbial cultures were obtained from the medical file. The study was approved by the institutional review board. Results As we foresee to finish our data analysis by the end of April 2015, we present results of our interim analysis here. Until now, a total of 178 FQ prescriptions in 79 children were analyzed. The majority of children had major comorbidities such as childhood cancer, cystic fibrosis or inflammatory bowel disease. FQ prescription was based on a microbial culture in 15.4% of cases. Frequent indications for FQ prescription were Pseudomonas eradication in cystic fibrosis patients, long term antibiotic prophylaxis in neutropenic patients and wound infections. Prescribed daily doses and consumed daily doses varied widely, even for the same indication. Concomitant medications were common and included mainly other antibiotics, steroids and chemotherapeutics. Conclusion FQ were used as ‘reserve antibiotic,' and so on-label, in a minority of all FQ prescriptions for hospitalized children.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".